Pub Date : 2026-03-01Epub Date: 2025-11-27DOI: 10.1016/j.ijregi.2025.100811
Rie Jul Christiansen , Caius Mortensen , Wojciech Cebula , Asta Lili Laugesen , Jacob Fyhring Mortensen , Michael Kemp , Anne Line Engsbro
We present the first Scandinavian cases of bacteremia caused by Ignatzschineria indica, I. ureiclastica, and Wohlfahrtiimonas chitiniclastica. Two patients with fly larvae-infested wounds were admitted to a Danish hospital in the summer of 2024. The first patient, a 62-year-old male with alcohol overuse and septic shock, had W. chitiniclastica and I. ureiclastica bacteremia, managed with piperacillin/tazobactam and ciprofloxacin. The second, a 67-year-old diabetic male with peripheral vascular disease, had I. indica bacteremia requiring below-knee amputation and targeted antibiotics. Both isolates were identified via MALDI-TOF mass spectrometry and whole-genome sequencing, with antibiotic “susceptibility testing” guiding therapy. Despite severe presentations, both patients survived. These cases highlight the emergence of these pathogens in Northern Europe and reinforce the importance of advanced diagnostics and personalized treatment strategies in myiasis-associated sepsis.
{"title":"The first report of Ignatzschineria indica, Ignatzschineria ureiclastica and Wohlfahrtiimonas chitiniclastica Bacteremia in two patients with fly larvae-infested wounds in Scandinavia","authors":"Rie Jul Christiansen , Caius Mortensen , Wojciech Cebula , Asta Lili Laugesen , Jacob Fyhring Mortensen , Michael Kemp , Anne Line Engsbro","doi":"10.1016/j.ijregi.2025.100811","DOIUrl":"10.1016/j.ijregi.2025.100811","url":null,"abstract":"<div><div>We present the first Scandinavian cases of bacteremia caused by <em>Ignatzschineria indica, I. ureiclastica</em>, and <em>Wohlfahrtiimonas chitiniclastica</em>. Two patients with fly larvae-infested wounds were admitted to a Danish hospital in the summer of 2024. The first patient, a 62-year-old male with alcohol overuse and septic shock, had <em>W. chitiniclastica</em> and <em>I. ureiclastica</em> bacteremia, managed with piperacillin/tazobactam and ciprofloxacin. The second, a 67-year-old diabetic male with peripheral vascular disease, had <em>I. indica</em> bacteremia requiring below-knee amputation and targeted antibiotics. Both isolates were identified via MALDI-TOF mass spectrometry and whole-genome sequencing, with antibiotic “susceptibility testing” guiding therapy. Despite severe presentations, both patients survived. These cases highlight the emergence of these pathogens in Northern Europe and reinforce the importance of advanced diagnostics and personalized treatment strategies in myiasis-associated sepsis.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100811"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-11-13DOI: 10.1016/j.ijregi.2025.100804
Amina Abukar Abdulle , Shafie Abdulkadir Hassan
Objectives
Maternal and neonatal tetanus (MNT) remains a major public health concern in Somalia, where health infrastructure is still recovering. Despite the availability of a safe and effective tetanus toxoid (TT) vaccine, coverage remains low. This study aimed to identify factors influencing TT vaccine uptake among reproductive-age women in Mogadishu, Somalia.
Methods
A community-based cross-sectional study was conducted from June to August 2025 in Mogadishu, Somalia. A two-stage cluster sampling technique combined with systematic random sampling was used to select 350 households. Data were collected using a structured, interviewer-administered questionnaire, and the primary outcome was adherence to at least two doses of the TT vaccine during pregnancy. Data were analyzed using bivariate and multivariable logistic regression to identify independent predictors of TT vaccine uptake.
Results
A total of 350 women participated in the study. Coverage of the TT vaccine was low, with only 19.7% receiving two or more doses during their last pregnancy. Multivariate analysis showed that women aged 36-49 years were more likely to be protected compared to those aged 15-25 years (AOR = 6.62; 95% confidence interval [CI]: 1.74-25.21; P = 0.006). Planned pregnancy was associated with higher protection (AOR = 8.35; 95% CI: 3.25-21.45; P <0.001). Attendance at health centers for antenatal care (AOR = 0.35; 95% CI: 0.18-0.69; P = 0.002), visits by health extension workers (AOR = 8.13; 95% CI: 4.35-15.22; P <0.001), and good behavior of health workers (AOR = 3.48; 95% CI: 1.15-10.46; P = 0.027) were positively associated with TT protection. Women from households with a monthly income below 57 US$ were significantly less likely to be protected (AOR = 0.04; 95% CI: 0.01-0.22; P <0.001).
Conclusions
TT vaccination coverage among women was low. Older age, planned pregnancy, antenatal care at health centers, visits by health extension workers, and good behavior of health workers were associated with higher protection, while low household income was linked to lower uptake. Strengthening targeted interventions is needed to improve TT coverage.
在卫生基础设施仍在恢复的索马里，孕产妇和新生儿破伤风仍然是一个主要的公共卫生问题。尽管有安全有效的破伤风类毒素疫苗，但覆盖率仍然很低。本研究旨在确定影响索马里摩加迪沙育龄妇女接种破伤风疫苗的因素。方法于2025年6 - 8月在索马里摩加迪沙进行了一项以社区为基础的横断面研究。采用两阶段整群抽样与系统随机抽样相结合的方法，选取了350户家庭。数据是通过结构化的访谈问卷收集的，主要结果是在怀孕期间坚持接种至少两剂TT疫苗。使用双变量和多变量逻辑回归分析数据，以确定TT疫苗摄取的独立预测因素。结果共有350名女性参与了这项研究。破伤风破伤风疫苗的覆盖率很低，只有19.7%的人在最后一次怀孕期间接种了两次或两次以上的疫苗。多因素分析显示，与15-25岁的女性相比，36-49岁的女性更有可能受到保护（AOR = 6.62； 95%可信区间[CI]: 1.74-25.21; P = 0.006）。计划妊娠与较高的保护相关（AOR = 8.35; 95% CI: 3.25-21.45; P <0.001）。到保健中心接受产前护理的人数（AOR = 0.35; 95% CI: 0.18-0.69; P = 0.002）、卫生推广工作者的就诊人数（AOR = 8.13; 95% CI: 4.35-15.22; P <0.001）和卫生工作者的良好行为（AOR = 3.48; 95% CI: 1.15-10.46; P = 0.027）与TT保护呈正相关。来自月收入低于57美元家庭的妇女得到保护的可能性明显较低（AOR = 0.04; 95% CI: 0.01-0.22; P <0.001）。结论妇女性传播疾病疫苗接种率低。年龄较大、计划怀孕、保健中心的产前护理、保健推广工作者的就诊以及保健工作者的良好行为与较高的保护程度有关，而家庭收入较低与较低的保护程度有关。需要加强有针对性的干预措施，以改善TT覆盖。
{"title":"Tetanus Toxoid Vaccine Uptake and Associated Factors Among Reproductive Age Women in Mogadishu, Somalia: A Cross-Sectional Study","authors":"Amina Abukar Abdulle , Shafie Abdulkadir Hassan","doi":"10.1016/j.ijregi.2025.100804","DOIUrl":"10.1016/j.ijregi.2025.100804","url":null,"abstract":"<div><h3>Objectives</h3><div>Maternal and neonatal tetanus (MNT) remains a major public health concern in Somalia, where health infrastructure is still recovering. Despite the availability of a safe and effective tetanus toxoid (TT) vaccine, coverage remains low. This study aimed to identify factors influencing TT vaccine uptake among reproductive-age women in Mogadishu, Somalia.</div></div><div><h3>Methods</h3><div>A community-based cross-sectional study was conducted from June to August 2025 in Mogadishu, Somalia. A two-stage cluster sampling technique combined with systematic random sampling was used to select 350 households. Data were collected using a structured, interviewer-administered questionnaire, and the primary outcome was adherence to at least two doses of the TT vaccine during pregnancy. Data were analyzed using bivariate and multivariable logistic regression to identify independent predictors of TT vaccine uptake.</div></div><div><h3>Results</h3><div>A total of 350 women participated in the study. Coverage of the TT vaccine was low, with only 19.7% receiving two or more doses during their last pregnancy. Multivariate analysis showed that women aged 36-49 years were more likely to be protected compared to those aged 15-25 years (AOR = 6.62; 95% confidence interval [CI]: 1.74-25.21; <em>P</em> = 0.006). Planned pregnancy was associated with higher protection (AOR = 8.35; 95% CI: 3.25-21.45; <em>P</em> <0.001). Attendance at health centers for antenatal care (AOR = 0.35; 95% CI: 0.18-0.69; <em>P</em> = 0.002), visits by health extension workers (AOR = 8.13; 95% CI: 4.35-15.22; <em>P</em> <0.001), and good behavior of health workers (AOR = 3.48; 95% CI: 1.15-10.46; <em>P</em> = 0.027) were positively associated with TT protection. Women from households with a monthly income below 57 US$ were significantly less likely to be protected (AOR = 0.04; 95% CI: 0.01-0.22; <em>P</em> <0.001).</div></div><div><h3>Conclusions</h3><div>TT vaccination coverage among women was low. Older age, planned pregnancy, antenatal care at health centers, visits by health extension workers, and good behavior of health workers were associated with higher protection, while low household income was linked to lower uptake. Strengthening targeted interventions is needed to improve TT coverage.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100804"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-13DOI: 10.1016/j.ijregi.2026.100857
Sung-Hsi Huang , Shu-Ying Chang , Bo-Huang Liou , Chia-Jui Yang , Po-Liang Lu , Luo-Wei Lin , Mei-Hui Lee , Pei-Ying Wu , Chi-Ying Lin , Chung-Yu Shih , Pei-Yu Wang , Mao-Song Tsai , Yuan-Ti Lee , Chien-Yu Cheng , Shu-Hsing Cheng , Chien-Ching Hung , Taiwan HIV Study Group
Objectives
The proportion of foreigners among newly diagnosed people with HIV in Taiwan has steadily increased. We evaluated HIV care quality indices among foreigners with HIV (FWH) and explored associated factors.
Methods
FWH who first sought care at 10 Taiwanese hospitals between 2017 and 2023 were included. Information on AIDS at presentation, antiretroviral therapy (ART) prescription, care retention, and viral suppression was collected. Factors associated with these indices were analyzed using logistic regression and Cox proportional hazards models.
Results
We included 144 FWH (median age of 32 years); 74.3% were from Southeast Asia. Overall, 58.3% remained in care at 1 year. Among 94 ART-naïve individuals, 47.9% presented with AIDS and 83.0% initiated ART; however, only 42.6% achieved viral suppression at 1 year. In multivariable analysis, white-collar occupations (vs blue-collar or unemployed) were associated with ART initiation (adjusted odds ratio [aOR], 5.481), while opportunistic infections decreased the odds (aOR, 0.284). ART prescription predicted care retention (adjusted hazard ratio, 6.03), and government-subsidized ART (vs self-funded ART) was linked to higher viral suppression rates (aOR, 3.817).
Conclusions
Substantial gaps in the HIV care cascade were observed among FWH in Taiwan. Strategies to promote earlier diagnosis and improve care retention are urgently needed.
{"title":"Exploring HIV care disparities among foreigners in Taiwan: Insights from a multicenter study (2017-2023)","authors":"Sung-Hsi Huang , Shu-Ying Chang , Bo-Huang Liou , Chia-Jui Yang , Po-Liang Lu , Luo-Wei Lin , Mei-Hui Lee , Pei-Ying Wu , Chi-Ying Lin , Chung-Yu Shih , Pei-Yu Wang , Mao-Song Tsai , Yuan-Ti Lee , Chien-Yu Cheng , Shu-Hsing Cheng , Chien-Ching Hung , Taiwan HIV Study Group","doi":"10.1016/j.ijregi.2026.100857","DOIUrl":"10.1016/j.ijregi.2026.100857","url":null,"abstract":"<div><h3>Objectives</h3><div>The proportion of foreigners among newly diagnosed people with HIV in Taiwan has steadily increased. We evaluated HIV care quality indices among foreigners with HIV (FWH) and explored associated factors.</div></div><div><h3>Methods</h3><div>FWH who first sought care at 10 Taiwanese hospitals between 2017 and 2023 were included. Information on AIDS at presentation, antiretroviral therapy (ART) prescription, care retention, and viral suppression was collected. Factors associated with these indices were analyzed using logistic regression and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>We included 144 FWH (median age of 32 years); 74.3% were from Southeast Asia. Overall, 58.3% remained in care at 1 year. Among 94 ART-naïve individuals, 47.9% presented with AIDS and 83.0% initiated ART; however, only 42.6% achieved viral suppression at 1 year. In multivariable analysis, white-collar occupations (vs blue-collar or unemployed) were associated with ART initiation (adjusted odds ratio [aOR], 5.481), while opportunistic infections decreased the odds (aOR, 0.284). ART prescription predicted care retention (adjusted hazard ratio, 6.03), and government-subsidized ART (vs self-funded ART) was linked to higher viral suppression rates (aOR, 3.817).</div></div><div><h3>Conclusions</h3><div>Substantial gaps in the HIV care cascade were observed among FWH in Taiwan. Strategies to promote earlier diagnosis and improve care retention are urgently needed.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100857"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-19DOI: 10.1016/j.ijregi.2025.100826
Yoshio Nakano, Hiroka Serizawa, Iwao Gohma
Capnocytophaga canimorsus sepsis is potentially fatal, even in immunocompetent hosts. This report describes a case involving a 57-year-old woman, who developed fever after a dog bite and initially presented without an evident focus. On the day of admission, she deteriorated to pulseless electrical activity during transport and achieved return of spontaneous circulation after approximately 23 minutes of resuscitation. Broad-spectrum antimicrobials (meropenem) were initiated for septic shock, and Capnocytophaga canimorsus subsequently grew in both the pre-admission and admission blood cultures. Peripheral discoloration suggested purpura fulminans. A precipitous decline in platelet count, schistocytosis, elevated lactate dehydrogenase levels, and acute kidney injury fulfilled the criteria for thrombotic microangiopathy, whereas ADAMTS13 activity was normal. Intensive care consisted of red blood cell and platelet transfusions, continuous hemodiafiltration transitioning to intermittent hemodialysis, mechanical ventilation with tracheostomy, and therapeutic plasma exchange once daily for three sessions. Hematological abnormalities resolved, schistocytes disappeared, organ dysfunction improved, and she was ultimately removed from ventilation and dialysis with full neurological recovery. This report describes survival after cardiopulmonary arrest due to Capnocytophaga canimorsus sepsis and suggests that plasma exchange may be a useful adjunct for secondary thrombotic microangiopathy in this setting. Early diagnosis, prompt antibiotic treatment, and multidisciplinary critical care are essential.
{"title":"Survival after cardiopulmonary arrest due to Capnocytophaga canimorsus sepsis: A case successfully managed using plasma exchange","authors":"Yoshio Nakano, Hiroka Serizawa, Iwao Gohma","doi":"10.1016/j.ijregi.2025.100826","DOIUrl":"10.1016/j.ijregi.2025.100826","url":null,"abstract":"<div><div>Capnocytophaga canimorsus sepsis is potentially fatal, even in immunocompetent hosts. This report describes a case involving a 57-year-old woman, who developed fever after a dog bite and initially presented without an evident focus. On the day of admission, she deteriorated to pulseless electrical activity during transport and achieved return of spontaneous circulation after approximately 23 minutes of resuscitation. Broad-spectrum antimicrobials (meropenem) were initiated for septic shock, and Capnocytophaga canimorsus subsequently grew in both the pre-admission and admission blood cultures. Peripheral discoloration suggested purpura fulminans. A precipitous decline in platelet count, schistocytosis, elevated lactate dehydrogenase levels, and acute kidney injury fulfilled the criteria for thrombotic microangiopathy, whereas ADAMTS13 activity was normal. Intensive care consisted of red blood cell and platelet transfusions, continuous hemodiafiltration transitioning to intermittent hemodialysis, mechanical ventilation with tracheostomy, and therapeutic plasma exchange once daily for three sessions. Hematological abnormalities resolved, schistocytes disappeared, organ dysfunction improved, and she was ultimately removed from ventilation and dialysis with full neurological recovery. This report describes survival after cardiopulmonary arrest due to Capnocytophaga canimorsus sepsis and suggests that plasma exchange may be a useful adjunct for secondary thrombotic microangiopathy in this setting. Early diagnosis, prompt antibiotic treatment, and multidisciplinary critical care are essential.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100826"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatitis B virus (HBV) remains a major public health challenge in sub-Saharan Africa, with mother-to-child transmission (MTCT) being the dominant route of infection. Timely administration of combined immunoprophylaxis HBV vaccine and hepatitis B immunoglobulin within 24 hours of birth is critical for prevention. However, maternal readiness to facilitate this intervention is poorly documented in Ghana. The study aimed to assess maternal preparedness for uptake of HBV immunoprophylaxis for exposed newborns in Northern Ghana and to identify associated predictors.
Methods
A cross-sectional study was conducted among 118 hepatitis B surface antigen-positive pregnant women attending antenatal care in 10 health facilities. Data were collected using a structured 10-item preparedness scale (α >0.70) and analyzed using SPSS v23. Descriptive statistics, chi-square tests, analysis of variance and multivariable logistic regression were applied to identify differences in preparedness scores across variables and predictors of preparedness.
Results
The mean preparedness score was 3.29 (SD = 0.70) reflecting an overall response between ‘agree’ and ‘strongly agree’ on the 5-point Likert scale. Based on percentage scores derived from the composite preparedness scale, 72% of women demonstrated high preparedness, while 28% were moderately prepared. None had poor preparedness. Preparedness was highest for perceived importance of immunoprophylaxis (M = 3.81) and knowledge of MTCT (M = 3.70). Lower mean scores were observed for financial readiness (M = 2.36) and adequacy of information from health providers (M = 2.57). Preparedness varied significantly by income category (P = 0.032) and family history of HBV (P = 0.042). Multivariable analysis showed tertiary education was negatively associated with preparedness (adjusted odds ratio = 0.13, 95% confidence interval: 0.02-0.76).
Conclusions
Maternal preparedness for HBV immunoprophylaxis in Northern Ghana was high, reflecting good awareness of MTCT prevention. However, financial constraints and insufficient provider information remain key barriers. Income-related differences highlight the need for cost-reduction strategies, while the negative association with tertiary education warrants further investigation. Strengthening antenatal counseling and integrating hepatitis B immunoglobulin into national financing schemes could improve equitable uptake and support HBV MTCT elimination efforts.
{"title":"Maternal preparedness for uptake of newborn hepatitis B immunoprophylaxis at birth: Implications for preventing mother-to-child transmission in resource-limited settings","authors":"Vivian Efua Senoo-Dogbey , Sharifa Iddrisu , Delali Adwoa Wuaku , Michael Darko Ashaley","doi":"10.1016/j.ijregi.2026.100846","DOIUrl":"10.1016/j.ijregi.2026.100846","url":null,"abstract":"<div><h3>Objectives</h3><div>Hepatitis B virus (HBV) remains a major public health challenge in sub-Saharan Africa, with mother-to-child transmission (MTCT) being the dominant route of infection. Timely administration of combined immunoprophylaxis HBV vaccine and hepatitis B immunoglobulin within 24 hours of birth is critical for prevention. However, maternal readiness to facilitate this intervention is poorly documented in Ghana. The study aimed to assess maternal preparedness for uptake of HBV immunoprophylaxis for exposed newborns in Northern Ghana and to identify associated predictors.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among 118 hepatitis B surface antigen-positive pregnant women attending antenatal care in 10 health facilities. Data were collected using a structured 10-item preparedness scale (α >0.70) and analyzed using SPSS v23. Descriptive statistics, chi-square tests, analysis of variance and multivariable logistic regression were applied to identify differences in preparedness scores across variables and predictors of preparedness.</div></div><div><h3>Results</h3><div>The mean preparedness score was 3.29 (SD = 0.70) reflecting an overall response between ‘agree’ and ‘strongly agree’ on the 5-point Likert scale. Based on percentage scores derived from the composite preparedness scale, 72% of women demonstrated high preparedness, while 28% were moderately prepared. None had poor preparedness. Preparedness was highest for perceived importance of immunoprophylaxis (M = 3.81) and knowledge of MTCT (M = 3.70). Lower mean scores were observed for financial readiness (M = 2.36) and adequacy of information from health providers (M = 2.57). Preparedness varied significantly by income category (<em>P</em> = 0.032) and family history of HBV (<em>P</em> = 0.042). Multivariable analysis showed tertiary education was negatively associated with preparedness (adjusted odds ratio = 0.13, 95% confidence interval: 0.02-0.76).</div></div><div><h3>Conclusions</h3><div>Maternal preparedness for HBV immunoprophylaxis in Northern Ghana was high, reflecting good awareness of MTCT prevention. However, financial constraints and insufficient provider information remain key barriers. Income-related differences highlight the need for cost-reduction strategies, while the negative association with tertiary education warrants further investigation. Strengthening antenatal counseling and integrating hepatitis B immunoglobulin into national financing schemes could improve equitable uptake and support HBV MTCT elimination efforts.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100846"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-24DOI: 10.1016/j.ijregi.2026.100849
Nurul Amirah Mohamad Farook , Adrian Anthony Pereira , Thana Seelan , Sabrina Di Gregorio , Nor Azila Muhammad Azami , Hui-min Neoh
Objectives
This study aimed to determine community carriage of methicillin-resistant Staphylococcus aureus (MRSA), S. epidermidis (MRSE), and S. haemolyticus (MRSH) among migrant workers from Indonesia, Bangladesh, and Nepal residing in Klang Valley, Malaysia.
Methods
A total of 258 migrant workers were recruited for nasal swab screening of MRSA, MRSH and MRSE. Swabs were cultured on CHROMagar™ MRSA, and colonies exhibiting growth were subjected to species identification, antibiotic susceptibility testing and SCCmec typing.
Results
Among 258 participants, 38 (14.7%) carried methicillin-resistant staphylococci (MRS), with Indonesian workers having the highest prevalence (n = 19, 50.0%). Among the MRS, MRSH was mostly commonly isolated (n = 18, 40.0%), followed by MRSA (n = 11, 24.4%) and MRSE (n = 2, 4.4%). Many isolates were resistant to erythromycin (n = 24, 53.3%), tetracycline (n = 17, 37.8%), ciprofloxacin (n = 17, 37.8%) and clindamycin (n = 17, 37.8%). SCCmec types I and V were predominantly found in MRSH (n = 20, 80.0%), while type IV was most common in MRSA (n = 10, 90.9%) and MRSE (n = 5, 55.6%).
Conclusions
This is the first report of community carriage MRS in migrant workers living in Malaysia. Silent MRS carriage in pink-collar industries, such as domestic helpers might have local community transmission implications and could be further investigated.
{"title":"Community carriage of methicillin-resistant staphylococci among migrant communities living in Klang Valley, Malaysia","authors":"Nurul Amirah Mohamad Farook , Adrian Anthony Pereira , Thana Seelan , Sabrina Di Gregorio , Nor Azila Muhammad Azami , Hui-min Neoh","doi":"10.1016/j.ijregi.2026.100849","DOIUrl":"10.1016/j.ijregi.2026.100849","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to determine community carriage of methicillin-resistant <em>Staphylococcus aureus</em> (MRSA), <em>S. epidermidis</em> (MRSE), and <em>S. haemolyticus</em> (MRSH) among migrant workers from Indonesia, Bangladesh, and Nepal residing in Klang Valley, Malaysia<em>.</em></div></div><div><h3>Methods</h3><div>A total of 258 migrant workers were recruited for nasal swab screening of MRSA, MRSH and MRSE. Swabs were cultured on CHROMagar™ MRSA, and colonies exhibiting growth were subjected to species identification, antibiotic susceptibility testing and SCC<em>mec</em> typing.</div></div><div><h3>Results</h3><div>Among 258 participants, 38 (14.7%) carried methicillin-resistant staphylococci (MRS), with Indonesian workers having the highest prevalence (n = 19, 50.0%). Among the MRS, MRSH was mostly commonly isolated (n = 18, 40.0%), followed by MRSA (n = 11, 24.4%) and MRSE (n = 2, 4.4%). Many isolates were resistant to erythromycin (n = 24, 53.3%), tetracycline (n = 17, 37.8%), ciprofloxacin (n = 17, 37.8%) and clindamycin (n = 17, 37.8%). SCC<em>mec</em> types I and V were predominantly found in MRSH (n = 20, 80.0%), while type IV was most common in MRSA (n = 10, 90.9%) and MRSE (n = 5, 55.6%).</div></div><div><h3>Conclusions</h3><div>This is the first report of community carriage MRS in migrant workers living in Malaysia. Silent MRS carriage in pink-collar industries, such as domestic helpers might have local community transmission implications and could be further investigated.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100849"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-11-29DOI: 10.1016/j.ijregi.2025.100816
Aristide Mounchili-Njifon , Abdou Fatawou Modiyinji , Pretty Rosereine Mbouyap , Chavely Gwladys Monamele , Moise Henri Moumbeket-Yifomnjou , Philipe Herman Njitoyap Mfombouot , Gisele Liliane Machuetum , Pascal Ibrahim Toueyem , Simon Frederic Lissock , Paul Alain Tagnouokam-Ngoupo , Jean Paul Assam Assam , Richard Njouom
Objectives
NS5B polymerase inhibitors are essential in the treatment of hepatitis C virus (HCV) infection. Although direct-acting antivirals (DAAs) are generally effective, their efficacy can be compromised by resistance mutations, particularly in the NS5B protein. This research aimed to identify naturally occurring mutations in the NS5B gene linked to DAA resistance in treatment-naïve Cameroonian patients with chronic hepatitis C.
Methods
Whole blood samples were collected from patients with chronic hepatitis C, from which plasma was subsequently separated and stored at –80°C for molecular analysis. The NS5B gene fragments were amplified using designated primers, and nucleotide sequences were acquired via the Sanger sequencing platform.
Results
Analysis of sequences revealed three genotypes: genotype 4 (38.49%), genotype 1 (38.38%), and genotype 2 (23.14%). The most prevalent subtypes were 4f (22.05%) and 1e (17.84%). The clinically significant S282T mutation, which confers high-level resistance to sofosbuvir, was detected in one patient infected with HCV genotype 1e. Similarly, the C316N substitution, associated with reduced susceptibility to non-nucleoside NS5B inhibitors, was identified in 16 patients, all belonging to genotype 1e. The Q309R mutation was detected in 19 genotype 1 sequences, and the L320F mutation was found in one genotype 4f sequence.
Conclusions
Our investigation revealed that HCV patients who had not previously received DAA therapy exhibited a variety of NS5B gene alterations. Consequently, future treatment failure may be more likely due to these alterations.
{"title":"Identification of NS5B resistance-associated mutations in hepatitis C virus circulating in treatment-naïve Cameroonian patients","authors":"Aristide Mounchili-Njifon , Abdou Fatawou Modiyinji , Pretty Rosereine Mbouyap , Chavely Gwladys Monamele , Moise Henri Moumbeket-Yifomnjou , Philipe Herman Njitoyap Mfombouot , Gisele Liliane Machuetum , Pascal Ibrahim Toueyem , Simon Frederic Lissock , Paul Alain Tagnouokam-Ngoupo , Jean Paul Assam Assam , Richard Njouom","doi":"10.1016/j.ijregi.2025.100816","DOIUrl":"10.1016/j.ijregi.2025.100816","url":null,"abstract":"<div><h3>Objectives</h3><div>NS5B polymerase inhibitors are essential in the treatment of hepatitis C virus (HCV) infection. Although direct-acting antivirals (DAAs) are generally effective, their efficacy can be compromised by resistance mutations, particularly in the NS5B protein. This research aimed to identify naturally occurring mutations in the NS5B gene linked to DAA resistance in treatment-naïve Cameroonian patients with chronic hepatitis C.</div></div><div><h3>Methods</h3><div>Whole blood samples were collected from patients with chronic hepatitis C, from which plasma was subsequently separated and stored at –80°C for molecular analysis. The NS5B gene fragments were amplified using designated primers, and nucleotide sequences were acquired via the Sanger sequencing platform.</div></div><div><h3>Results</h3><div>Analysis of sequences revealed three genotypes: genotype 4 (38.49%), genotype 1 (38.38%), and genotype 2 (23.14%). The most prevalent subtypes were 4f (22.05%) and 1e (17.84%). The clinically significant S282T mutation, which confers high-level resistance to sofosbuvir, was detected in one patient infected with HCV genotype 1e. Similarly, the C316N substitution, associated with reduced susceptibility to non-nucleoside NS5B inhibitors, was identified in 16 patients, all belonging to genotype 1e. The Q309R mutation was detected in 19 genotype 1 sequences, and the L320F mutation was found in one genotype 4f sequence.</div></div><div><h3>Conclusions</h3><div>Our investigation revealed that HCV patients who had not previously received DAA therapy exhibited a variety of NS5B gene alterations. Consequently, future treatment failure may be more likely due to these alterations.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100816"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study evaluates seroprevalence of diphtheria toxoid immunoglobulin G antibodies among displaced populations in Abyan Governorate, which is to the best of our knowledge the first such assessment in Yemen’s conflict setting.
Methods
A cross-sectional study in 390 displaced individuals (aged 1 month–90 years) assessed anti-diphtheria antibody levels through enzyme-linked immunosorbent assay. Geometric mean titers (GMTs) and seroprotection rates were analyzed by age, gender, and vaccination status.
Results
Overall seroprotection was 76.2%, with 23.8% susceptible (<0.01 IU/ml). GMTs decreased significantly with age (1.04 IU/ml in those aged ≤10 years vs 0.78 IU/ml in those aged >40 years; P <0.05). Alarmingly, 63.8% of adults aged ≥40 years lacked protection. Although GMTs showed no gender difference (males: 1.04 ± 0.17; females: 1.05 ± 0.23 IU/ml), males had higher long-term protection (56.3% vs 44.0%, P <0.05). Individuals vaccinated exhibited better protection (56.0% vs 35.5%, P <0.05), yet 15.3% remained susceptible, suggesting cold-chain or dosing failures.
Conclusions
Yemen’s displaced populations face critical immunity gaps, particularly among older adults. Suboptimal vaccine effectiveness and decreasing immunity underscore the need for: targeted booster campaigns for adults; strengthened vaccine delivery systems; and integrated serosurveillance in conflict zones. These findings provide evidence for revising national immunization strategies in humanitarian crises.
本研究评估了阿比扬省流离失所人群中白喉类毒素免疫球蛋白G抗体的血清患病率，据我们所知，这是也门冲突环境中首次进行此类评估。方法对390例流离失所者（年龄1个月- 90岁）进行横断面研究，通过酶联免疫吸附法检测抗白喉抗体水平。几何平均滴度（GMTs）和血清保护率按年龄、性别和疫苗接种状况进行分析。结果总保护率为76.2%，易感率为23.8% （0.01 IU/ml）。GMTs随年龄的增长而显著降低（≤10岁组为1.04 IU/ml，≤40岁组为0.78 IU/ml; P <0.05）。令人震惊的是，63.8%的≥40岁的成年人缺乏保护。虽然GMTs没有性别差异（男性：1.04±0.17；女性：1.05±0.23 IU/ml），但男性具有更高的长期保护作用（56.3% vs 44.0%, P <0.05）。接种疫苗的个体表现出更好的保护（56.0%对35.5%,P <0.05），但15.3%仍然易感，这表明冷链或剂量失败。结论：叙利亚流离失所者面临严重的免疫缺口，尤其是老年人。疫苗效力欠佳和免疫力下降突出表明需要：针对成人开展有针对性的加强运动；加强疫苗输送系统；以及冲突地区的综合服务监控。这些发现为修订人道主义危机中的国家免疫战略提供了证据。
{"title":"Critical immunity gaps: Waning diphtheria protection among Yemen’s displaced populations calls for urgent booster strategies","authors":"Nazeh Al-Abd , Olawale Quazim Junaid , Abeer Ali Alausji , Abdulkhaleq Faiz Ben Laswed , Moataz Anwar Albehani , Sagir Mustapha , Omar Bamaga","doi":"10.1016/j.ijregi.2026.100861","DOIUrl":"10.1016/j.ijregi.2026.100861","url":null,"abstract":"<div><h3>Objectives</h3><div>This study evaluates seroprevalence of diphtheria toxoid immunoglobulin G antibodies among displaced populations in Abyan Governorate, which is to the best of our knowledge the first such assessment in Yemen’s conflict setting.</div></div><div><h3>Methods</h3><div>A cross-sectional study in 390 displaced individuals (aged 1 month–90 years) assessed anti-diphtheria antibody levels through enzyme-linked immunosorbent assay. Geometric mean titers (GMTs) and seroprotection rates were analyzed by age, gender, and vaccination status.</div></div><div><h3>Results</h3><div>Overall seroprotection was 76.2%, with 23.8% susceptible (<0.01 IU/ml). GMTs decreased significantly with age (1.04 IU/ml in those aged ≤10 years vs 0.78 IU/ml in those aged >40 years; <em>P</em> <0.05). Alarmingly, 63.8% of adults aged ≥40 years lacked protection. Although GMTs showed no gender difference (males: 1.04 ± 0.17; females: 1.05 ± 0.23 IU/ml), males had higher long-term protection (56.3% vs 44.0%, <em>P</em> <0.05). Individuals vaccinated exhibited better protection (56.0% vs 35.5%, <em>P</em> <0.05), yet 15.3% remained susceptible, suggesting cold-chain or dosing failures.</div></div><div><h3>Conclusions</h3><div>Yemen’s displaced populations face critical immunity gaps, particularly among older adults. Suboptimal vaccine effectiveness and decreasing immunity underscore the need for: targeted booster campaigns for adults; strengthened vaccine delivery systems; and integrated serosurveillance in conflict zones. These findings provide evidence for revising national immunization strategies in humanitarian crises.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100861"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuberculosis (TB) is a major global health crisis exacerbated by conflict and displacement. These factors disrupt health care and create overcrowded, unsanitary conditions that accelerate TB spread. This study investigated pulmonary TB epidemiology among refugees, internally displaced persons, and host communities in northwestern Ethiopia.
Methods
A multicenter cross-sectional study was conducted from July 1 to September 30, 2024 at Dabat and Metema refugee sites in northwestern Ethiopia. In this study, 1350 sputum samples were tested using GeneXpert MTB/RIF, with culture performed on Löwenstein–Jensen medium. Data were analyzed in IBM SPSS Statistics, Version 27 using logistic regression, with model fitness assessed to ensure reliable findings.
Results
Among 1350 study participants in northwestern Ethiopia, 56% were male, with a mean age of 35.29 years. The prevalence of Xpert MTB/RIF–confirmed TB was 102 cases (7.56%), of which 80 (78.4%) were culture-confirmed. Multivariable logistic regression identified several factors significantly associated with TB infection, such as cigarette smoking, recent TB contact, occupational exposure, diabetes, limited health care access, prolonged camp stay, alcohol consumption, biomass smoke exposure, weight loss, and shortness of breath.
Conclusions
This study demonstrated a high prevalence of Mycobacterium tuberculosis among conflict-affected displaced populations. Diabetes mellitus, smoking, recent TB contact, alcohol use, biomass smoke exposure, prolonged camp residence, and poor health care access were identified as significant risk factors.
结核病（TB）是一种主要的全球卫生危机，因冲突和流离失所而加剧。这些因素扰乱了卫生保健，造成过度拥挤和不卫生的条件，加速了结核病的传播。本研究调查了埃塞俄比亚西北部难民、国内流离失所者和收容社区的肺结核流行病学。方法于2024年7月1日至9月30日在埃塞俄比亚西北部Dabat和Metema难民营进行多中心横断面研究。本研究使用GeneXpert MTB/RIF对1350份痰样本进行检测，并在Löwenstein-Jensen培养基上进行培养。在IBM SPSS Statistics， Version 27中使用逻辑回归分析数据，评估模型适应度以确保结果可靠。结果在埃塞俄比亚西北部1350名研究参与者中，56%为男性，平均年龄35.29岁。Xpert MTB/ rif确诊结核102例（7.56%），其中培养确诊80例（78.4%）。多变量logistic回归确定了与结核病感染显著相关的几个因素，如吸烟、最近接触结核病、职业暴露、糖尿病、有限的卫生保健机会、长时间营地停留、饮酒、生物质烟雾暴露、体重减轻和呼吸短促。结论：本研究表明，在受冲突影响的流离失所人群中，结核分枝杆菌的患病率很高。糖尿病、吸烟、最近接触结核病、饮酒、生物质烟雾暴露、长时间在营地居住以及难以获得卫生保健被确定为重要的危险因素。
{"title":"Prevalence of Mycobacterium tuberculosis and risk factors among internally and externally displaced populations in northwestern Ethiopia: The case of Dabat and Metema","authors":"Deresse Daka , Belay Tessema , Awelani Mutshembele , Amir Alelign , Wubet Birhan , Baye Gelaw","doi":"10.1016/j.ijregi.2025.100836","DOIUrl":"10.1016/j.ijregi.2025.100836","url":null,"abstract":"<div><h3>Objectives</h3><div>Tuberculosis (TB) is a major global health crisis exacerbated by conflict and displacement. These factors disrupt health care and create overcrowded, unsanitary conditions that accelerate TB spread. This study investigated pulmonary TB epidemiology among refugees, internally displaced persons, and host communities in northwestern Ethiopia.</div></div><div><h3>Methods</h3><div>A multicenter cross-sectional study was conducted from July 1 to September 30, 2024 at Dabat and Metema refugee sites in northwestern Ethiopia. In this study, 1350 sputum samples were tested using GeneXpert MTB/RIF, with culture performed on Löwenstein–Jensen medium. Data were analyzed in IBM SPSS Statistics, Version 27 using logistic regression, with model fitness assessed to ensure reliable findings.</div></div><div><h3>Results</h3><div>Among 1350 study participants in northwestern Ethiopia, 56% were male, with a mean age of 35.29 years. The prevalence of Xpert MTB/RIF–confirmed TB was 102 cases (7.56%), of which 80 (78.4%) were culture-confirmed. Multivariable logistic regression identified several factors significantly associated with TB infection, such as cigarette smoking, recent TB contact, occupational exposure, diabetes, limited health care access, prolonged camp stay, alcohol consumption, biomass smoke exposure, weight loss, and shortness of breath.</div></div><div><h3>Conclusions</h3><div>This study demonstrated a high prevalence of <em>Mycobacterium tuberculosis</em> among conflict-affected displaced populations. Diabetes mellitus, smoking, recent TB contact, alcohol use, biomass smoke exposure, prolonged camp residence, and poor health care access were identified as significant risk factors.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100836"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-15DOI: 10.1016/j.ijregi.2026.100847
Sohail Adnan, Farid Hussain, Sarfraz Khan
Background
Drug-resistant tuberculosis (TB) of the brain and spine is difficult to sample for culture. It poses a significant challenge to physicians in low- and middle-income countries.
Methods
We present three patients of drug-resistant tuberculosis and demonstrate how we manage them in limited resources.
Case Series
Multi drug-resistant (MDR1): a young female patient had cerebellar tuberculomas at presentation. While being on conventional antituberculous therapy (ATT), she developed meningitis, and deteriorated with impaired conscious-level. Later, patient sustained ischemic strokes. Second-line ATT improved her condition. Treatment course was complicated by peripheral neuropathy, and psychotic behavior.
MDR2, a middle-aged woman having type-II diabetes was diagnosed with lumbar spondylitis. She was on conventional ATT for 1 year. Severe backache relapsed within a month of discontinuation of treatment. We started her on empirical second-line treatment. She had a dramatic response in pain and completely recovered at 1 year.
MDR3, a middle-aged woman had spondylitic changes at D10-D11 vertebral bodies on magnetic resonance imaging. The pain showed sub-optimum response to conventional ATT. The hyperintense signal changes resolved at 1 year of treatment with levofloxacin and linezolid.
Conclusion
These outcomes will raise physicians’ awareness of the need for early suspicion, and timely initiation of second-line therapy.
{"title":"Clinical approach to drug-resistant tuberculosis of the brain and spine in a low-income setting: A case series","authors":"Sohail Adnan, Farid Hussain, Sarfraz Khan","doi":"10.1016/j.ijregi.2026.100847","DOIUrl":"10.1016/j.ijregi.2026.100847","url":null,"abstract":"<div><h3>Background</h3><div>Drug-resistant tuberculosis (TB) of the brain and spine is difficult to sample for culture. It poses a significant challenge to physicians in low- and middle-income countries.</div></div><div><h3>Methods</h3><div>We present three patients of drug-resistant tuberculosis and demonstrate how we manage them in limited resources.</div></div><div><h3>Case Series</h3><div>Multi drug-resistant (MDR1): a young female patient had cerebellar tuberculomas at presentation. While being on conventional antituberculous therapy (ATT), she developed meningitis, and deteriorated with impaired conscious-level. Later, patient sustained ischemic strokes. Second-line ATT improved her condition. Treatment course was complicated by peripheral neuropathy, and psychotic behavior.</div><div>MDR2, a middle-aged woman having type-II diabetes was diagnosed with lumbar spondylitis. She was on conventional ATT for 1 year. Severe backache relapsed within a month of discontinuation of treatment. We started her on empirical second-line treatment. She had a dramatic response in pain and completely recovered at 1 year.</div><div>MDR3, a middle-aged woman had spondylitic changes at D10-D11 vertebral bodies on magnetic resonance imaging. The pain showed sub-optimum response to conventional ATT. The hyperintense signal changes resolved at 1 year of treatment with levofloxacin and linezolid.</div></div><div><h3>Conclusion</h3><div>These outcomes will raise physicians’ awareness of the need for early suspicion, and timely initiation of second-line therapy.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100847"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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